I bet none of the questions ask; 'How close are you to 100% recovery?' Without that single question this is all useless.
Value-Based Stroke Rehabilitation: Feasibility and Results of Patient-Reported Outcome Measures in the First Year After Stroke
Author links open overlay panelI.F.GroeneveldPhD*†‡
Abstract
Purpose
Structured application of patient-reported outcome measures (PROMs) is a key element in Value Based Healthcare.
This study aimed to evaluate the feasibility of a broad set of PROMs
reflecting similar patient reported health domains as proposed within
the International Standard Set of Patient-Centered Outcome Measures After Stroke within the first year after stroke.
Methods
The study included consecutive stroke patients admitted to inpatient or outpatient specialized rehabilitation.
PROMs were administered upon admission, discharge (inpatients only),
and at 3, 6, and 12 months. PROMs included: EuroQol 5 Dimensions
(EQ-5D), Stroke Impact Scale (SIS), Stroke and Aphasia Quality of Life Scale (SAQOL-39NL), Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P), Hospital Anxiety and Depression Scale (HADS), and Fatigue Severity Scale (FSS). Feasibility was defined as participation, retention, and response rates. Paired t tests were conducted to analyze their changes over time.
Results
Of
485 inpatients and 189 outpatients who were invited, 291 (60.0%) and 82
(43.3%) participated, of whom 45 (15.5%) and 7 (8.5%) dropped out
before 12 months, respectively. Two hundred seven (71.1%) and 71 (86.6%)
of the inpatients and outpatients returned the questionnaires on all or
all but one time points, respectively. Between admission and 12 months
statistically significant improvements of PROMs addressing general
health and quality of life (EQ-5D), psychiatric functioning (HADS),
motor functioning (SIS mobility), and social functioning (USER-P, SIS communication) were seen. The SIS memory scale, the SAQOL-39NL and the FSS did not show any changes.
Conclusions
Participation,
retention, and response rates for a comprehensive set of PROMS for
stroke in patients in rehabilitation were moderate to good, with
clinical improvements seen until 1 year post stroke. The SAQOL-39NL and
FSS did not demonstrate changes over time and cannot be recommended for
repetitive measurements in this setting. By simplifying the set of questionnaires, participation and response rates may be further enhanced.
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